According to a Harvard study, about one-third of women experience hair loss (alopecia) at some time in their lives, and two-thirds of those are in post-menopausal women.

Hair loss in women is less socially acceptable than in men, affecting them socially and emotionally.

Causes of alopecia can be hormonal, stress related, traction alopecia (tight braids or ponytails) and chemotherapy, with the most common cause being genetic, called female-pattern baldness.

First, one must seek professional help to diagnose the cause, and then plan the treatment.

Once the diagnosis is made and treatment decided upon, replacement of the lost hair might involve a hair transplant. This is a procedure whereby the hair follicles are transplanted from the back of the scalp to the balding areas.

This is performed under local anesthesia, with or without sedation, according to the patient’s wishes. The skill involves removing the proper number of follicles to give good hair density in the balding areas, while not removing too many follicles and leaving the donor site too thin.

Additional skill is necessary to place the follicles in the proper direction so hair grows in the direction of the surrounding hair. Each graft must have one to four follicles to look completely natural and not look “plugged.”

FUT (follicular unit transplantation) and FUE (follicular unit extraction) are common acronyms. Generally, FUT involves removing a strip of scalp from the back, and cutting this strip into small units of one to four follicles. FUE procedures, such as the NeoGraft, involve removing the grafts with a small 1-millimeter punch instead of a strip. The grafts are virtually the same.

The advantage of the NeoGraft is no linear scar in the back of the scalp. The disadvantage is a large amount of hair must be cut very short in the donor area, leaving a temporary bald area until the hair grows out, which might take months with longer hair.

The disadvantages of the strip include the need for suture removal at 10 to 12 days and the linear scar, which is virtually imperceptible with longer hair.

The advantages are there is no need to cut hair short in the donor area; and every follicle for transplantation can be taken from the area with the most hair density for thicker hair for transplantation in most cases.

Plus, the procedure is faster, which is important with hair transplants. The time between extraction and implantation is shorter so the follicles are back with a blood supply faster for maximum hair follicle health.

For these reasons, while both techniques are excellent, according to the patient’s choice, most females opt for the strip method of transplantation, leaving them with a full head of hair in the back of the scalp. Most men with shorter hair choose the NeoGraft.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton.